Young Doctors Are About to Work Much Longer Hours

By:

Kyle Jaeger

Even as a majority of physicians report experiencing some effects of burnout, doctors will soon be allowed to work 28-hour shifts — 12 hours longer than current restrictions permit

A private committee of hospital executives and health professionals voted in favor of the shift extension on Friday, arguing that existing limitations had a negative impact on the education of first-year medical residents.

Those limitations were imposed in 2011 in response to concerns about how prolonged shifts increased the risk of interns inadvertently harming patients or themselves. Studies have found that going more than 24 hours without sleep can inhibit your ability to focus and impair cognition, similar to alcohol intoxication.

"In one study, interns working in the intensive care unit for 24 hours or longer made 36 percent more serious medical errors than those working shorter shifts," The Los Angeles Times reported.

The logic behind longer shifts maintains that interns need to observe patients' illnesses progress over extensive periods of time in order to learn how to best treat them.

"I was never really satisfied with that answer," one physician wrote in a Reddit thread responding to a question about why doctors work long shifts. The real answer is multifaceted, he said, but it primarily comes down to tradition.

"Medicine has a very strong sense of tradition. It is a hierarchical structure and is deeply committed to the preservation of standards. I found it to be very much like the military.

There's also a case to be made that repeatedly transitioning teams throughout the day can be bad for patients, as Dr. Mara Gordon, a medical resident at the University of Pennsylvania, wrote for STAT News.

"Suddenly, the providers who planned how to take care of a patient have left the hospital, and the new team is responsible for picking up midstream. It’s like stepping in to a movie that’s already half over. And just as certainly as I have made mistakes after being awake for more than 24 hours, I have also made mistakes when taking over the care of a complicated patient in the middle of his or her hospital stay."

At the same time, subjecting interns to 28-hour shifts could contribute to workplace burnout. About 54 percent of physicians included in a 2014 Mayo Clinic survey reported experiencing at least one symptom of burnout — up almost 20 percent since 2011.

50% of US doctors are suffering from burnout; 50% of our work time is now spent with the #EHR and not patients. Coincidence? Hmm.

"Extreme sleep deprivation and long hours are a holdover from the early 20th century when residents literally resided in the hospitals in which they trained," Dr. Kelly Thibert, president of the American Medical Student Association, said in a press release responding to the new policy. "There is no reason to continue to subject medical trainees to mental and physical exhaustion for years on end, with the harm that ensues to them, their families and their patients, simply to maintain an archaic tradition."